The Essay Covers Human Body Elements, Diabetes Pathogenesis, COPD, Myocardial Infarction, And Drug Types.

G 1. List the main elements of the human body?

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2. Define homeostasis?

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3. Describe the difference between facilitated diffusion, diffusion and osmosis?

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4. Explain the difference between passive and active transport systems?

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5. Define and describe the difference between hypertrophy and atrophy?

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Assessment Guide

Date created: April 2017 Version: 1.0

Date implemented: Next review: April 2019 Responsibility: Chief Operations Officer

6. Define and describe the difference between hyperplasia and metaplasia

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7. What is the normal average range for a body temperature for the following age groups?
8. a) Newborn
9. b) Infant
10. c) 10 – 14 year old
11. d) Adult
12. e) Older adult

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8. What is inflammation and list the five (5) cardinal features of Inflammation?

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9. How could you recognise signs and symptoms relative to trauma (penetrating, blunt)?

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10. What is the average normal range for blood pressure in the following age groups?
11. a) New-born
12. b) Infant
13. c) 10 – 14 year old
14. d) Adult
15. e) Older adult

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Document: HLTAAP003 Student

Assessment Guide

Date created: April 2017 Version: 1.0

Date implemented: Next review: April 2019 Responsibility: Chief Operations Officer

11. Define what Diabetes is? Your answer should include burden of disease, types of diabetes,

pathogenesis and pathophysiology, risk factors, and prevention.

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12. Simon is 14 years old, admitted with severe LIR abdominal pain and fever, diagnosed with severe

appendicitis. If he were left untreated, what would the result be?

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13. What is the average pulse rate in the following age groups?
14. f) New-born
15. g) Infant
16. h) 10 – 14 year old
17. i) Adult
18. j) Older adult

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14. What is Hypertension and define the types of hypertension?

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15. What is the pathophysiology of Herpes Zoster (shingles)?

Types of diabetes

1. Human body is comprised of six elements including oxygen, carbon, hydrogen, calcium, nitrogen and phosphorus. 99% of the human body mass is composed of these elements. 65% consists of oxygen, 18% carbon, 10% hydrogen, 3% nitrogen, 1.5% calcium and 1.0% phosphorus.  
2. Homeostasis is the characteristics of the system to regulate the internal environment in a way to achieve a stable state. Stable condition denotes optimal functioning of the human body and achieving stable condition is dependent on many other variables such as body temperature, fluid balance and others.
3. Diffusion is the movement of the molecules from a high concentration to low concentration. It may occur with or without semi-permeable membrane. In contrast, the main feature of facilitated diffusion is that it requires the presence of an integral membrane protein for passive movement of molecules along the concentration gradient. Permease present in the semi-permeable membrane facilitates the diffusion of molecules.

In addition, osmosis is the movement of water or solvent from low concentration to high concentration through a semi-permeable membrane. The main difference between osmosis and diffusion is that both solvent and solute move from one region to another, however for osmosis, only solvent can move across the membrane.

4. Active transport system is the movement of molecule from low concentration to a high concentration in a direction against the concentration gradient. This type of movement is dependent on the use of cell’s energy such as adenosine triphosphate (ATP). Utilization of energy is important to move against the electrochemical gradient. In contrast, the main difference between passive transport compared to active transport is that it does require energy input to facilitate movement of molecules. In contrast, another difference between active and passive transport is that in active transport, molecules or ions moves from low concentration to high concentration compared to movement from high to low concentration in passive transport system
5. Hypertrophy is the process of enlargement of muscles due to growth in size of component cells. In contrast, atrophy is the decrease in size of a body part or wasting away of body part. The main difference is that in hypertrophy, the number of cells of the affected organ remains the same although size increases and in atrophy, the reduction in size of organ is associated with decrease in the number of cells.
6. Hyperplasia is the increase in size of organs or tissues due to the increase in the number of cells. This mainly occurs because of cellular proliferation. In contrast, metaplasia is the reversible change in the covering of an organ or gland and its conversion into another form in response to a stimulus. The process replaces one differentiated somatic cell type with another differentiated cell type.
7. The normal average range of body temperature for the below mentioned age group are as follows:
8. a) Newborn: 97.9 degree F  to 99°F
9. b) Infant:  97.9 degree F  to 99°F
10. c) 10 – 14 year old: 96.6 to 99.7
11. d) Adult:  97 to 99 degree F
12. e) Older adult: less than 98.6 degree F
13. Inflammation: Inflammation is the immune system’s response to injury or wounds resulting in swollen and reddened area near the wounds. This process is mediated by white blood cells which are released into the blood after injury or tissue damage. This process of release in white blood cells results in redness. It is regarded as a protective process and the increase in the number inflammatory cells results in irritation, swelling and pain. The five cardinal features of inflammation are as follows:

• Redness
• Warmth
• Swelling
• Pain
• Loss of function

Acute inflammation is identified by the above mentioned five cardinal signs.

9. Penetrable blunt trauma refers to a form of physical trauma caused to a body part either by injury or physical attack. The injury may be causes by a blunt force trauma such as collision from heavy objects like motor vehicles. The sign and symptoms of blunt trauma may differ based on the region of injury. Injury to the abdominal cavity is one of the major causes of trauma related fatalities. Penetrating trauma is easy to recognize due to the cause of injury. However, identifying signs and symptoms of blunt trauma is difficult because of abdominal injury. Abdominal trauma can be identified by abdominal assessment. The first process is to assess vital signs. Blood pressure and heart rate assessment can help to get cues regarding internal bleeding. The abdomen of patient can be checked for signs of abdominal injury such as distension, bruising and exit wounds. Palpation of abdomen quadrants is done to check for signs of tenderness. CT scans can also help to identify injury to sensitive organs of the abdomen (McGrath and Whiting 2015).  
10. The average normal range for blood pressure in different age groups are as follows:
11. a) New-born:60-85/45-55
12. b) Infant: 80/50
13. c) 10 – 14 year old:55-85/ 58-90
14. d) Adult:120/80
15. e) Older adult: 140/90
16. Definition of diabetes: Diabetes is a group of metabolic disorders that involve an elevation in the levels of blood glucose, over a prolonged period of time. Some of the kost common symptoms of the condition encompass frequent thirst, urination, and increased appetite. This occurs due to inefficiency of the pancreas in producing insulin or failure of the cells in responding to the insulin produced in the body.

Types of diabetes: There are three main types of diabetes mellitus that are given below:

• Type 1 DM- this occurs due to failure of the pancreas to produce adequate insulin hormone. Previously referred to as insulin dependent diabetes, the exact cause for this is unknown. However, a combination of environmental and genetic factors are responsible for the onset of this health abnormality (Kerner and Brückel 2014)
• Type 2 DM- This typically develops with insulin resistance where the cells are unable to repond appropriately to insulin hormone. With a progress in the disease, there might occur a lack of insulin. Insufficient exercise, sedentary lifestyle and body weight are the major contributing factors.
• Gestational diabetes- This occurs with the development of high blood sugar levels among pregnant women, without any history of diabetes.

Burden of disease- An estimated 1.2 million individuals aged 2 years and above are diagnosed with diabetes in Australia. 85% people of those diagnosed with diabetes, reported symptoms of T2D, in 2014-2015. T1D was reported by 13.5% people. An estimated 6,091 children were found to suffer from diabetes in the year 2013. T2D is also overrepresented among the indigenous population with 12.8% of them, aged more than 15 years suffering from diabetes in 2014-2015. Furthermore, according to the National Perinatal Data Collection estimated that 6% of the women who had given birth from 2009-2011, suffered from gestational diabetes (Health.gov.au 2018).

Pathogenesis and pathophysiology- Insulin is the primary hormone regulating glucose uptake from the blood cells to different parts of the body, especially the adipose tissue, liver, and muscles, except the smooth muscles, where the insulin hormone acts via the IGF-1. Thus, insulin deficiency of insulin insensitivity of its receptors are integral in the onset of all forms of diabetes. The beta cells of the islets of Langerhans release the insulin hormone, in response to elevated blood glucose levels. Upon encountering insufficient amounts of insulin, or inefficiency of the cells to respond to the effects of the hormone, commonly referred to as insulin resistance, or insulin sensitivity, the body cells will fail to absorb glucose properly, thereby contributing to a failure in its storage in the muscles and liver (Cryer 2016). This will result in persistently high blood glucose levels, poor protein synthesis, and acidosis.

Risk factors: Diabetes is associated with a range of risk factors such as, chronic renal failure and cardiovascular disease. Poor dietary patterns, family history, insufficient physical activity, and failure to maintain a healthy abdominal weight are some of the risk factors that contribute to this chronic disease (Satman et al. 2013).

Prevention: T2D is most often prevented by normal body weight maintenance, engagement in physical activity, and adoption of healthy diet patterns. Dietary modifications such as consuming a diet rich in fiber, whole grains, polyunsaturated fats, and limiting the intake of sugar content greatly reduces risks of diabetes. Furthermore, tobacco cessation is also related to reduction in risks of diabetes (Kahn, Cooper and Del Prato 2014).

12. Simon has been diagnosed with severe appendicitis and suffering from LIR abdominal pain and fever. If he is left untreated, then the inflamed appendix may burst causing spillage of infectious agents into the abdominal cavity. This can lead to peritonitis and even death in patient unless treatment is initiated for Simon.
13. The average pulse rate in the following age group are as follows:
14. a. New born: 120-160 beats per minute
15. Infant: 80-160 beats per minute
16. 10-14 year old: 60- 100 beats per minute
17. Adult:60- 100 beats per minute
18. Older adult: 60- 100 beats per minute (Medline Plus, 2018)
19. Hypertension:It is a clinical condition associated with elevated blood pressure in the arteries. Patients diagnosed with hypertension have elevated blood pressure exceeding the normal range of 120/80. There are two types of hypertension which are as follows:

• Primary hypertension: Primary hypertension is most common and no underlying disease is the cause behind hypertension.It mainly occurs due to influence of genes, diet and lifestyle.
• Secondary hypertension: It is the rare form of hypertension which  is caused because of diseases like kidney failure and sleep apnea.

15. Pathophysiology of Herpes Zoster (shingles): Herpes Zoster is a viral disease conditioncaused by reactivation of varicella-zoster virus.The primary clinical manifestation of Herpes Zoster is chicken pox. The infectious virus present in chicken pox vesicle expands and travels to sensory ganglia through the sensory nerves and develops latent infection in the sensory neurone. The varicella-zoster virus reactivates and spreads within the ganglion causing intense inflammation and neuronal necrosis. The virus then moves back from the sensory ganglion to the nerves found in the skin to form rashes in the skin (Oxman 2009).
16. COPD: COPD is a chronic inflammatory condition associated withbreathing difficulties and poor airflow from the lungs. People diagnosed with COPD experience symptoms of breathlessness, wheezing, shortness of breath and cough with or without mucus (Young and J. Hopkins, 2014).

Burden of disease- estimated cases and indigenous population status

Burden of Disease: The burden of COPD is understood from the fact that in 2015, almost 3.2 million people died from COPD worldwide and the increase in death was 11.6% compared to 1990.  The prevalence of the disease has increased by 44.2% since 1990 resulting in disease burden and increase in health care cost (Soriano et al. 2017).

Pathogenesis and pathophysiology: The main characteristics features of COPD are airway obstruction and abnormal inflammatory response in the lungs. Long term exposure to noxious gases initiates amplified innate and adaptive immune response. This amplified response is the reason behind tissue destruction, hypersecretion and airway inflammation (Berg and Wright 2016).

Risk factor and prevention: Long term exposure to smoke, dust and chemicals increase the risk of COPD. The disease can be prevented by delivery of smoking cessation intervention in high risk individual and avoid exposure to lung irritants (Young and J. Hopkins, 2014).

17. Myocardial infarction (MI): It is a clinical condition that results in disruption of blood flow to the heart muscle caused because of blockage of one or more arteries.

Burden of Disease: The burden of the disease is understood from the prevalence of MI and death rate due to MI in Australia. MI is a type of cardiovascular disease and the number of deaths attributed due to MI in Australia in 2016 is 43, 963. Each year, 54,000 people suffer heart attack and average of 22 Australians died from heart attack in 2016 (Heart Foundation. 2017).

Pathogenesis and pathophysiology: Occlusive intracoronary thrombus and superficial plaque thrombus are involved in the pathogenesis of MI. Thombotic occlusion is the main cause of MI that results because of the rupture of plaque. Ischemia results in ionic changes in the myocardium and necrosis of the cardiomyocytes in the infarcted heart. Clearance of dead cells activates anti-inflammatory pathways resulting in disruption of cytokine signaling and activation of rennin-angiotensin-aldosterone system. These processes are characterised by progressive dysfunction in affected individual (Frangogiannis 2015).

Risk factor and prevention:

Abdominal obesity, smoking, unhealthy diet and psychosocial stress are some risk factor of myocardial infarction (MO). For patients at high risk of myocardial infarction, primary prevention strategies are essential to reduce the risk of MI. It includes increasing physical activity, encouraging smoking cessation and reducing body weight of patients (Åkesson et al. 2014).

18. For patient diagnosed with CHF, checking weight daily is important to track fluid accumulation in the body and check whether patient is recovering from heart failure or their conditions are deteriorating. Checking weight gives idea about level of fluid retention and detection of clinical symptoms of heart failure. Regular detection of weight gain can help to prevent progression of the disease (Wang et al. 2014).
19. Inability to regulate pH can result in risk of degenerative diseases such as diabetes, kidney failure and cancer. Inability to regulate pH results may result in poor absorption of nutrients and chances of diseases.
20. Discharge planning is the process of goal setting in which plan is made regarding coordination of services after discharge of patient. It aims to promote health of patient by considering patient needs.
21. When the immune system is not responding as expected, the affected individual may be susceptible to risk of diseases and infection. The protective measures that is necessary for such individual is to implement hygiene practices to prevent themselves from any complication.
22. Genetic mutations and damage to the DNA plays a role of the pathophysiology behind breast cancer. The expression of estrogen receptors like alpha and beta plays a role in the carcinogenesis of breast. The tumorigenic effects of estrogen such as the genotoxic effect of estrogen metabolites and the hormonal properties of estrogen that induce cancer cells proliferation plays a role in the development of carcinoma of the breast (Dabbs 2016).
23. Cervical cancer is caused by Human Papilloma Virus (HPV) being the greatest risk factor carcinoma of the cervix. Type 16 and 18 HPV causes 75% of cervical cancers as it is considered as the vector that confers susceptibility towards a neoplastic conversion inciting transmutation to malignancy in the epithelial cells. The transformation of neoplasm occurs at the squamocolumnar cervical junction with varying degrees graded I to III depending upon lesion severity (Miranda and Podolsky 2016).
24. Endometriosis is the presence of endometrial glands or tumor in the ovaries and the peritoneum. It results because of the transport and deposition of viable endometrial cells in the ovary. The cells back flow through the fallopian tubes and deposits on the pelvic organ. This explains the pathophysiology behind endometriosis (Hufnagel et al. 2015).  
25. Schizophrenia is a mental disorder that is complex in nature and is caused by dysregulation of various pathways involved in neurotransmitter systems like glutamatergic, Dopaminergic and GABAergic systems. The interactions between these system receptors are affected and that contribute to the pathophysiology of schizophrenia lie dysfunctioning of neurons, immune system and myelination abnormalities and oxidative stress (Steullet et al. 2016).
26. Polycystic kidney disease (PKD) is a genetic disorder (autosomal dominant/recessive trait) that causes chronic renal failure characterized by fluid-filled cysts accumulation in the kidney. Recent research has suggested that primary abnormality leads to cyst formation in both the genetic forms mediated by defects in the signalling activity of cilia or primary cilium present on most body cells (Jha et al. 2013).
27. Glomerulonephritis is the glomerular injury and inflammation that may result in renal failure. Although, it is poorly understood, immunological damage to response is the main reason for pathogenesis. This response activates a number of biological processes like cytokines and growth factors release, complement activation and leukocyte recruitment that results in glomerular injury (Johnson, Feehally and Floege 2014).
28. The main pathogenesis for Cushing Syndrome is cortisol-secreting adenoma or excess cortisol present in the cortex of adrenal gland called primary hypercortisolism/hypercorticism. In this case, the adenoma is responsible for elevating the cortisol levels in the blood that causes negative feedback directly on the pituitary from high levels causing adrenocorticotropin to become low (Isidori et al. 2015).
29. Addison disease or adrenal insufficiency or hypocortisolism is characterized by outer layer destruction of adrenal glands located above the kidneys. This disease is caused by adrenal failure that results in decreased cortisol production and aldosterone leading to negative feedback on ACTH, plasma and renin activity elevated due to adrenal failure (Charmandari, Nicolaides and Chrousos 2014).
30. In hypothyroidism, there is decreased T4 production causing an increase in TSH secretion by pituitary gland. The hypothalamic–pituitary–thyroid axis plays a crucial role in the maintenance of levels of thyroid hormone in normal range. TSH production by anterior part of pituitary gland is stimulated by the axis that is released from hypothalamus. Thereafter, TSH and TRH production is decreased via negative feedback process by thyroxine. This results in less TRH leading to less TSH and thereby less production of thyroid hormone (McCance and Huether 2015).
31. Macular degeneration is deteriorative process in eyes residing in retinal pigment epithelium (RPE) from high rate molecular degradation. Lipofuscin are residual bodies of incomplete degeneration that are damaged in RPE cells or parts of phagocytised cone and rod membranes. Progressive RPE degeneration causes further deterioration resulting in loss of vision (Ambati, Atkinson and Gelfand 2013).   
32. Urge incontinence is characterized by involuntary loss of urine related to urgency. This is caused by failure in storage function in the lower urinary tract or inappropriate bladder activity of detrusor muscle or incompetency in mechanisms of continence maintenance. However, the main theory that supports incontinence is stress and urge.
33. Neoplasm is the excessive or abnormal tissue growth that is uncoordinated as compared to normal tissues surrounding it forming a mass.

Benign tumours	Malignant tumours
Grows rapidly	Slow-growing
Invade tissues and penetrate basal membrane	Does not invade
Spread to other body parts	Grows in the same place
abnormal DNA and chromosomes, darker and larger nuclei	Normal cellular appearance

34.  Dysphagia refers to the disorder which gives rise to difficulty in swallowing and takes more time in the movement of food or liquid from the mouth into the stomach. The causes includes neurological causes, congenital and developmental causes, obstruction in the throat and muscular conditions. To provide care assistance can be given during swallowing. Constant monitoring required for signs of coughing and gaging which can be detrimental.
35. A medical emergency which occurs when the body starts loosing heat more than the heat produced by the body is referred to as hypothermia.
36. The vital observation are observing the body temperature, measuring the pulse rate, the respiration rate and the blood pressure and the body weight.
37. Celiac Disease and the Crohn's Disease. This occurs when the immune system attacks the digestive tract thereby causing inflammation, swelling and scarring of the digestive tract.
38. Resuscitation

39. Tracheotomy is a surgical method which ensures breathing by incision of the trachea in the neck to aloe breathing. Endotracheal intubation is a method which ensures the airway channelling by inserting a tube through the nose or the mouth to help in breathing.
40. The adrenaline effects the sympathetic nervous system by accelerating the heart rate and elevating the blood pressure. It also increases the rate of breathing. Stimulates glycogenolysis in the liver.
41. a) Antiarrhythmic agents- Treats cardiac arrhythmias.

Qunidine- Class 1 Antiarrhythmic

Contraindicated in patients where cardiac rhythm is dependent upon an ectopic pacemaker.

Indicated to be used in patients with no structural or organic heart diseases.

1. b) treat hypertension

Trandolapril

Indication-Treatment of normal renin & high renin hypertension

 Contradiction- acute renal failure in patients with bilateral renal artery stenosis

1. C) Beta blockers are drugs that bind to beta-adrenoceptors and thereby block the binding of norepinephrine and epinephrine to these receptors.

Pathogenesis and pathophysiology of diabetes

Indications- treats hypertension

Contradiction- induce cardiogenic shock

1. d) Loop diuretics are powerful drugs that help that works to inhibit the sodium-potassium-chloride co-transporter in the thick ascending loop of Henle

Indications- Effective in decreasing the blood pressure more than other diuretics

Contradiction- may cause anuria in case of electrolyte imbalance.

1. E) Type of nonsteroidal anti-inflammatory drug (NSAID) that directly targets cyclooxygenase-2, COX-2, an enzyme responsible for inflammation and pain. 

Celecoxib

Indications-Relief from the symptoms of osteoarthritis

Contradiction- Patients with severe renal insufficiency

1. F) An ergot derivative that selectively stimulates D2 dopamine receptors to treat Parkinson disease

Parlode

Indications- treat endocrinologic disorders, especially hyperprolactemia

Contradiction- avoid in patients with peripheral vascular disease

1. g) Blocks neuromuscular transmission at the neuromuscular junction

Pancuronium

Indications- required for tracheal intubation in adults

Contradiction- short-acting depolarizing agent.

1. h) Prevents or reduces blood coagulation which prolongs the time of clotting

Warfarin

Indications- treatment of venous thrombosis

Contradiction- can cross the placenta & cause a hemorrhagic disorder in the fetus

I ) Drugs that block the action of acetylcholine.

Dicylomine

Indications- treats chronic obstructive pulmonary disease (COPD)

Contradiction- Heat exhaustion and heat stroke

1. j) Promote reduction of lipid levels in the blood.

Moxidectin

Indications- reduce triglyceride levels

Contradiction- upper respiratory tract infection

42. Growth is a process of expanding or becoming large over a period of time.It is a term which depicts quantitative enlargement of a particular thing.

Whereas development is a wider term and includes growth i.e it is more of a comprehensive concept which not only includes quantitative enlargement but also includes qualitative expansion.

43. Factors are heredity, sex, socioeconomic factors, Nutrition, Hormones and Pollution
44. A)Piaget's Cognitive Developmental Theory

1. b)Bowlby's Attachment Theory

1. c)Bandura's Social Learning Theory

1. D)Vygotsky's Sociocultural Theory

1. e) Field theory
2. f) Michael Commons' model of hierarchical complexity.
3. g)Faith development theory.
4. h)Emergent cyclic levels of existence theory.
5. I)  theory of identity achievement and identity status.
6. A) Avoid infant mortality
7. b) Proper growth and well being

1. c) Day care and proper mental growth
2. d) Improving health and health protection and promotion activities
3. e) Health improvement within the context of families, communities and health care systems.

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